[Neuromeningeal cryptococcosis in non-HIV patients to CHU ward of Point G in Bamako (Mali): 3 case report].
We report 3 clinical observations of neuromeningeal cryptococcosis which occurred without any immunodepression related to HIV infection. Our patients were male. They did not present any particular medical history indicating a diagnosis of cryptococcosis. Nevertheless we found a professional exposure to the risk of inhalation of C. neoformans capsules. The diagnosis was based on presence of encapsulated yeast of Cryptococcus in the direct exam by China ink and culture on Sabouraud medium. CD4 lymphocytic count was done in two patients (case 1:899 cells/mm3; case 2:347 cells/mm3). Idiopathic lymphocytopenia was noted in one case. Co-morbidity of 5. pneumoniae meningitis was reported in one patient (case 3). Treatment was based on injectable amphotericin B in monotherapy (case 1), followed by perfusion of fluconazole cure (case 2). Case 3 was treated by perfusion of amphotericin B associated with ceftriaxone (case 2). No secondary prophylactic treatment was administered. Evolution was favorable after follow-up of 5 years (case 1) and of 4 years (case 2). The third patient died during hospitalization.
Minta
D K
DK
Service des maladies infectieuses, CHU du Point G, BP 333, Bamako, Mali.
Dembélé
M
M
Diarra
A S
AS
Sidibé
A T
AT
Konaté
A
A
Diarra
M
M
Coulibaly
I
I
Maïga
I I
II
Traoré
A K
AK
Maïga
M Y
MY
Doumbo
O K
OK
Traoré
H A
HA
Pichard
E
E
Chabasse
D
D
D000328:Adult; D000666:Amphotericin B / Q000627:therapeutic use; D000935:Antifungal Agents / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D003455:Cryptococcus neoformans / Q000302:isolation & purification; D017809:Fatal Outcome; D015725:Fluconazole / Q000627:therapeutic use; D018023:HIV Seronegativity; D006801:Humans; D008297:Male; D016919:Meningitis, Cryptococcal / Q000175:diagnosis* / Q000188:drug therapy; D008875:Middle Aged; D016896:Treatment Outcome
D000935:Antifungal Agents; D002443:Ceftriaxone; D000666:Amphotericin B; D015725:Fluconazole